Ms J, 23, female, student
PC: irritability x 1/7 duration
HPC: associated with extremely unpredicted mood changes. irritated to any sort of things her eyes may see or the ears can listen. this is not the first time. the symptoms are cyclical, usually more prominent before she gets the menses, namely about 35 days interval.
symptoms are preceded by extreme lethargy, apathy, and the duration is about 2 to 3 days. she also complained of abdominal cramps that lasted for few minutes, back pain and abdominal bloating of unknown cause.
2 weeks prior to that symptom, she will crave for any high sugar-content food or chocolates.
no fever, no vomitting, no neck stiffness. no UTI or any other abdominal symptoms.
Past medical, past surgical and family histories are insignificant.
On social history, she is concerned on how her mood can affect the people around her where she sometimes cannot really contained her irritability and worried that her apathic state becomes so repulsive to people around her.
Management based on the history:
1. watch funny movies as much as possible
2. talk to someone she is comfortable with
3. drink more sugar to increase energy level
4. apply hot water on abdomen
5. have a good rest
6. breath in and out every time she is upset or feeling down
